Intravenous drug users and their sexual partners are a major at- risk population for AIDS because they often share unclean needles and engage in unprotected sex. Since AIDS is lethal, immediate intervention is needed to reduce risk behaviors. The major goal of this proposal is to implement a community-based outreach program and examine it's effectiveness. This program is being integrated into the existing AIDS prevention efforts within Seattle and King County. The basic intervention used is the community health outreach worker (CHOW) modeled on the successful program in San Francisco. CHOWs are streetwise, matched to the populations they serve, and trained to intercede by providing knowledge and skills-training in both safe needle and sex practices. In addition to the CHOWs, components of a more comprehensive intervention program are planned to facilitate CHOW activities. Community organizers will augment the communities' awareness of the problem and gain support. The primary research question addressed concerns differences in CHOW activities which might facilitate intervention. Using a quasi-experimental method, two CHOW programs will be implemented into four different but matched neighborhoods. Standard CHOWs will act individually to effect behavior as does the San Francisco CHOW. The "meta-CHOW" will be identical but trained to recruit IV drug users and their sexual partners to participate in the intervention. We hypothesize that while both CHOWs will be successful in reducing risk behavior, meta-CHOWs will have a greater and more rapid impact. In addition, meta-CHOWs may produce behavioral changes more resistant to relapse. We will obtain data on the effectiveness of the interventions from the project's participation in the national survey, from research by ethnographic field workers, and from AIDS counseling and testing. We will monitor the change over time of risk behaviors at monthly intervals by ethnography and every 6 months using the national survey instrument. This will allow determination of program outcome, compare effectiveness of CHOW programs, and assess rates of behavior change for each intervention. This rate analysis will be the basis for deciding if one intervention is superior to the other.